{template common/header_ajax}
<h3 class="flb">
	<em>{lang aljbd:s245}</em>
		<span><a href="javascript:;" class="flbc" onclick="hideWindow('$_GET['handlekey']');" title="{lang close}">{lang close}</a></span>
	
</h3>
<iframe name="formsubmit" width="1" height="1" ></iframe>
<form id="addbc" method="post" action="{ADMINSCRIPT}?action=plugins&operation=config&do={$_GET['do']}&identifier=aljbd&pmod=admin&act=iwantclaim"  target="formsubmit">
<input name="formhash" type="hidden" value="{FORMHASH}" />
<input name="bid" type="hidden" value="{$_GET['bid']}" />
		<div class="c">
        
        
        	<table cellspacing="0" cellpadding="0" border="0">
                
  				<tbody>
				<tr>
				<td width="110" height="30"><span style="color:red;">*</span>{lang aljbd:s246}</td>
				<td colspan="4">
					<input type="text" name="name"><b style="color:red">{lang aljbd:s247}</b>
				</td>
				</tr>                            
            </tbody></table>
	
</div>
<p class="o pns">
	<button type="submit" name="submit" value="true" class="pn pnc"><strong>{lang aljbd:s35}</strong></button>
</p>
</form>
{template common/footer_ajax}